Halbreich U. Postpartum disorders: multiple interacting underlying mechanisms and risk factors. J Affect Disord 88, 1-7

Journal of Affective Disorders (Impact Factor: 3.38). 10/2005; 88(1):1-7. DOI: 10.1016/j.jad.2005.05.002
Source: PubMed
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    • "Unfortunately, the risk factors related to PP are poorly understood. Various studies have highlighted several risk factors such as primiparity,[3] pregnancy complications,[4] obstetric complications,[5] cesarean section,[6] female baby,[7] lack of social support,[8] history of affective illness,[9] stressful life events,[4] estrogen withdrawal,[10] family history of psychosis,[11] sleep loss,[12] and many others.[13] "
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    ABSTRACT: Background:A better understanding of risk factors associated with postpartum psychosis may contribute to the better management.Aims:This study was to identify the risk factors contributing to postpartum psychosis.Materials and Methods:In this cross-sectional, case control study 100 patients of postpartum psychosis (PP) were compared with the healthy controls. Risk factors explored were sociodemographic factors (age, education, occupation, income, and family type); positive family history; pregnancy and perinatal factors (number of antenatal check-up, parity, and complications during pregnancy, perinatal phase or in newborn); and presence of husband during peripartum period. Data were analyzed by graph pad instat software using chi square test and Fisher's exact test.Results:Total of 64% patients and 42% controls were less than 25 years of age (P = 0.001). Among the patients, 62% were primiparae compared with 46% in the controls (P = 0.02). Per capita family income was less than 5000 INR in 72% patients and 56% controls (P = 0.01). Maternal complications during perinatal period were observed in 38% patients and 22% controls (P = 0.01), while the complications in newborns were seen in 21% patients and 8% controls (P = 0.009). Husband was present in 58% patients and 76% controls. (P = 0.006).Conclusions:The risk factors related to PP were younger age, lower per capita income, perinatal and neonatal complications, and absence of husband in peripartum phase.
    North American Journal of Medical Sciences 06/2014; 6(6):274-7. DOI:10.4103/1947-2714.134373
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    • "Postpartum depression (PPD) is a psychiatric disorder, defined as a subtype of major depressive disorder (MDD). It has been reported that 10–15% women suffer from PPD following childbirth [1]. Although the underlying etiology of postpartum depression remains unknown, the abrupt changes in reproductive hormones that women undergo in post-delivery period may cause postpartum depression [2]. "
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    ABSTRACT: Postpartum depression (PPD) is a psychiatric disorder that occurs in 10-15% of childbearing women. It is hypothesized that omega-3 fatty acids, which are components of fish oil, may attenuate depression symptoms. In order to examine this hypothesis, the animal model of postpartum depression was established in the present study. Ovariectomized female rats underwent hormone-simulated pregnancy (HSP) regimen and received progesterone and estradiol benzoate or vehicle for 23 days, mimicking the actual rat's pregnancy. The days after hormone termination were considered as the postpartum period. Forced feeding of menhaden fish oil, as a source of omega-3, with three doses of 1, 3, and 9g/kg/d, fluoxetine 15mg/kg/d, and distilled water 2ml/d per rat started in five postpartum-induced and one vehicle group on postpartum day 1 and continued for 15 consecutive days. On postpartum day 15, all groups were tested in the forced swimming test (FST) and open field test (OFT), followed by a biochemical assay. Results showed that the postpartum-induced rats not treated with menhaden fish oil, exhibited an increase in immobility time seen in FST, hippocampal concentration of corticosterone and plasmatic level of corticosterone, and pro-inflammatory cytokines. These depression-related effects were attenuated by supplementation of menhaden fish oil with doses of 3 and 9g/kg. Moreover, results of rats supplemented with menhaden fish oil were comparable to rats treated with the clinically effective antidepressant, fluoxetine. Taken together, these results suggest that menhaden fish oil, rich in omega-3, exerts beneficial effect on postpartum depression and decreases the biomarkers related to depression such as corticosterone and pro-inflammatory cytokines.
    Behavioural Brain Research 05/2014; 271. DOI:10.1016/j.bbr.2014.05.036 · 3.03 Impact Factor
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    • "The postpartum period can therefore be considered a time of readjustment by the HPA axis to placental CRH withdrawal (Hochberg, Pacak, & Chrousos, 2003). Abnormally high levels of pCRH in pregnancy, followed by their subsequent, precipitous withdrawal, have been hypothesized to trigger postpartum depression in vulnerable individuals (Chrousos et al., 1998; Halbreich, 2005; Hochberg et al., 2003; Magiakou et al., 1996; Vitoratos, Papatheodorou, Kalantaridou, & Mastorakos, 2006). Despite the wider literature linking HPA axis dysregulation to depression in the nonpregnant state, only a few studies have investigated whether pCRH shifts during pregnancy pose a risk factor for postpartum depression. "
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    ABSTRACT: Three decades of research point to both biological and psychological risk factors for postpartum depression, but very little research integrates the two. This study bridged this gap by testing whether prenatal social support predicted depressive symptoms at 8 weeks postpartum in a multiethnic sample of 210 women and whether the stress hormone placental corticotropin-releasing hormone (pCRH), measured at 19, 29, and 37 weeks' gestation, mediated this relationship. We found that prenatal family support predicted significantly fewer depressive symptoms postpartum and more gradual increases in pCRH from 29 to 37 weeks' gestation. Furthermore, steeper increases in pCRH during this same period predicted more depressive symptoms postpartum. Finally, these changes in pCRH in late pregnancy mediated the relationship between prenatal family support and postpartum depressive symptoms. These results suggest that social and biological risk factors for postpartum depressive symptoms are intertwined and move us closer to an integrated biopsychosocial understanding of postpartum depression.
    07/2013; 1(3):253-264. DOI:10.1177/2167702612470646
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